When Han was in his sixties, he was diagnosed with a torn hemangioma at Yan Chai Hospital in Tsuen Wan and urgently needed to be transferred to another hospital. However, he wanted to be transferred to Kwong Wah Hospital, which was on the same network and had relevant equipment, but refused 4 times that night on the grounds that the patient was seriously ill. The patient had to be transferred across the network to Queen Mary Hospital for surgery, but died 9 days after staying in the hospital.
The Coroner’s Court conducted an inquest on the cause of his death. Vascular surgery experts believed that considering the patient’s condition at the time, if he could have received appropriate treatment at that time, the probability of death was only half.
The deceased, Cai Zhide (67 years old), had retired at the time of the incident. He died in Queen Mary Hospital on April 3, 2019, and the Hospital Authority was listed as an interested party.
death from acute myocardial infarction
The court revealed that Cai felt unwell on the night of March 25, 2019. He was sent to Yan Chai Hospital in the early morning of the next day, and then transferred to Queen Mary Hospital for surgery. Due to excessive blood loss, he developed liver failure and fell into a coma until his death on April 3 of the same year.
Pathologist Huang Dezhao said that after the occurrence of atherosclerosis in Cai's blood vessels, the blood vessel tumors were torn, leading to acute myocardial infarction, which was the direct cause of his death.
The deceased Cai Zhide was initially sent to Renji Hospital.
(Photo by Weng Yuhui)
Experts believe that Guanghua should accept Cai
Liu Runhuang, chair professor of Chinese University, testified as a vascular surgery expert today. He pointed out that according to medical data, if Cai received appropriate treatment, there was a half chance of death, and Cai was not too old at the time. Being able to recover the heartbeat, I think Kwong Wah Hospital should accept Cai.
Liu also said that if he refuses everything, the relevant hospitals may have moral and criminal risks, and in the network of hospitals, hospitals with vascular departments should be responsible for the patients in their area, even if the patients have accidents during the transfer, It is the responsibility of the hospital where the patient was originally located.
Liu agrees that according to the guidelines, patients on inotropic drugs should not be transferred, because the use of inotropic drugs can be interpreted as a patient's unstable condition.
Guanghua pointed out that Cai's upward pressure was lower than 80 at that time
Liang Guoda, a surgeon at Renji Hospital, testified earlier that computer scans showed Cai’s abdominal aorta was torn, but the hospital did not have a vascular surgery department, so they referred the patient to Kwong Wah Hospital or Princess Margaret Hospital on the same network according to the guidelines. , who was on duty that day was Guanghua Hospital.
However, Kwong Wah pointed out that the patient’s upper pressure was lower than 80 at that time, and it was not suitable to be transferred. Cai’s upper pressure was 71 at 3:00 a.m. and he was still awake.
One hour later, Cai's pressure rose to 88, and Renji asked to be transferred to another hospital. Guanghua replied that this was a sign of increasing the dose of cardiotonic drugs, so he refused again.
Liang disagreed with the decision and directly called Huang Shanheng, the deputy consultant doctor of Kwong Wah Hospital, but Huang still refused his request.
Liang said that the victim's heart stopped at about 4 o'clock in the morning, and then he recovered. He believed that Cai was still alive, and arranged for Cai to be transferred to Queen Mary Hospital on the same morning.
The consultant doctor believed that Cai was at high risk of being transferred to another hospital
Huang Shanheng, deputy consultant doctor of Guanghua Hospital, said that the patient's blood pressure was low, and increasing the dose of cardiotonic drugs meant that his condition was unstable. He believed that his condition would continue to deteriorate. He believed that the transfer was extremely risky, so he refused to accept the patient.
Huang also said that it takes time to transport patients and prepare the operating room. It is expected that Cai's heart may stop during the transfer, and he cannot support the transfer to the hospital for surgery.
He agreed with Renji or felt that he was dying, but at that time he only felt that Cai should not be transferred to another hospital, but he did not rule out that if Cai got better, he might be suitable.
Closing arguments will be given at the hearing tomorrow.
Case number: CCDI 272/19
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